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Can International Relief Do More Good Than Harm?

One soldier wanted to light a cigarette, so he walked off into the bush, found two sticks and started rubbing them together. I gave him a lighter. We had landed not long before on a ragged airstrip in the Nuba Mountains of Sudan, a place all but cut off from the outside world for the last decade. It is short of matches and most everything else. Even five years ago, many Nuba were naked, and they talk about it with great shame; their clothes simply eroded from their bodies, as if from scarecrows a few autumns on.

The Nuba Mountains are, by geography and an endless civil war, one of the most remote places in Africa. There are no roads. No cars or telephones. There is so little that when warplanes sent by the government of Sudan dropped three bombs on a school last winter -- blasting 13 children and a teacher to their deaths -- farmers gathered up pieces of shrapnel to use as hoes.

The bombing ''is killing them, but they are also benefiting,'' says Jacob Idris, my guide on a trip there, as he walks past an olive bomb shard sitting alongside a plot of sorghum. He laughs, but barely.

The Nuba Mountains also prove the point, apparent now for several years, that there is no such thing as a simple act of charity.

In the last decade or so, the machinery of compassion has churned its righteous way into a succession of faraway wars: Ethiopia, Sudan, Somalia, Bosnia, Zaire, Kosovo. But for all the mouths fed, the easy rock-star sloganeering of the 1980's Ethiopian famine (''Feed the world!'') has been flattened by a more complicated reality -- international relief can do more harm than good.

Indeed, aid workers seem embarrassed now to talk about ''doing good.'' They prefer ''doing no harm.'' The seemingly straightforward act of dropping food into a war zone can, paradoxically, help keep that war going. In a place like Sudan, an unstable giant on the Horn of Africa, years of work and billions of dollars have produced little concrete improvement in the recipients' lives, and certainly not peace.

''You save lives, perhaps, but you pay a huge price,'' says John Ryle, a British author and aid consultant who works often in Sudan. ''It's kind of a hopeless profession, really, if it's a profession at all.''

The question is not whether aid has failed outright, as a grim chorus of critics would have it. The world would not be better if the rich stayed home. The issue is whether aid can work better, and the Nuba Mountains are putting that to a tricky test. Within the next few months, the United Nations expects permission from the Sudanese government -- denied for years -- to finally begin regular relief flights there.

This time, though, the U.N. is trying something different. Rather than bombarding villages with bags of grain from low-flying cargo planes, it will offer help that is small in scale and not at all telegenic. It will be delivered by the U.N. and a dozen private aid groups almost entirely through the Nuba people themselves. This will, in theory, give the Nuba control over what they receive -- and what they do not. Except in times of extreme famine, there will be no deliveries of food, the prime commodity and raison d'tre of pure relief the world over. Instead, the U.N. will concentrate on ''capacity building,'' providing things that help the Nuba help themselves: seeds and tools (actual hoes, not bomb shards), medicine, clean water, materials for schools.

The Nuba have insisted on this minimalism. They have seen aid's shortcomings in other parts of Sudan, where relief is the only real business (apart, of course, from war itself). They have gone it alone for years and want nothing to destroy their tough self-reliance. Yet the Nuba are routinely bombed by Sudan's government, starved off their farms and cleansed of their unique identity as descendants of escapees from Arab slave caravans who live as if the modern world had not yet come. They have next to nothing, so in that sense they need aid desperately.

''It's going to be difficult for them to handle,'' says a European aid worker advising Nuba's leaders on the strange question of how not to be hurt when the world wants to help. ''As one commander said, 'We are blinded by our need.'''

It is uncommon in war for the ''affected populations,'' as aid workers often call those who must live with the fighting, to turn down something free. But Yousif Kowa, the leader of the Nuba, is becoming well known for it, and that may bode well for Nuba. Kowa, for 15 years the Nuba's military commander, has always had unusually firm ideas of what the Nuba need and do not. He once refused a planeload of metal cookware. ''I said, 'Why do you think we need that?''' he recalls. ''In the Nuba Mountains, we make our pots of clay. We need other things.''

We spoke one morning in his office in Nairobi, Kenya, where many Sudanese rebels live and plan their war, now nearly 17 years old, against the government in the north. I had gone to get permission to travel to Nuba. I also wanted to meet one of the few rebel leaders in Sudan considered honest and straight-talking, even by skeptical diplomats and aid officials. Some use the word ''hero,'' which makes it all the sadder that Kowa is dying, at age 55, of prostate cancer.

''Cancer is something they don't have an easy cure for,'' he says. ''So that is it.''

The bitter drop of fatalism in his voice may refer to his own life, but not to the survival of the Nuba people, whose history is wrapped in romanticism about a purer Africa. ''In the heart of Sudan, and to the west of the White Nile,'' George Rodger, a Life photographer, wrote after a trip to Nuba in 1948, ''there is a strange, unreal land which the hand of time has hardly touched in passing.'' Though the Nuba Mountains have been cut off by war for a decade, they have never really been part of the wider world. They are hidden geographically, some 30,000 square miles of rocky hills in the shape of a horseshoe, which is roughly the size of South Carolina, in a nation as big as everything east of the Mississippi.

In a country dominated by Muslims in the north, Nuba culture was all its own. The Nuba wrestled. They fought with bracelet knives and sticks, worshiped their own gods and slathered their bodies with oil and chalk and paint in dances for fertility of the earth or the female body.

Above all, they were naked, fabulously so, some even into the 1970's. But clothes, in the form of Arab robes, became one way that the Muslims in the north sought to reshape the Nuba after independence from the British in 1956. They taught the Nuba in Arabic rather than in Nuba languages. They forced conversions to Islam, from Christianity or animist religions.

In the mid-1980's, the Nuba, under Kowa's command, joined the larger war in Sudan that pits rebels from the southern part of Sudan, many of them Christians, against the Islamicist government, based in the northern city of Khartoum. That has made the Nuba Mountains an island of rebellion in an area that should be solid territory for the government -- and that is close to oil fields that began pumping hundreds of millions of dollars of crude in the last two years. The Nuba's war is, in many ways, cultural. They are fighting, alone, for greater independence and to revive their rich, almost Stone Age existence.

''I am proud to be a Nuban, not an Arab,'' says Abdarahman Ajur, a small-time trader and explosive talker I met one day at a market that was notable only for how little it had to offer. ''An Arab is everything I have nothing to do with.''

Odd as it might sound, Kowa makes clear that unchecked humanitarianism is another threat to the Nuba people. He believes that relief -- particularly food -- creates dependence, as many argue welfare does in the United States. Kowa recalls a trip in 1993 to an area in southern Sudan that had received much food aid from the United Nations. ''The people of the area are great farmers,'' he says. ''But because there is this relief food, they did not farm for three years. I could see the difficulty. It was spoiling people. They just sleep and have food. It is very bad.''

The international effort in southern Sudan has come to symbolize all that is right and wrong about aid. In 11 years, Operation Lifeline Sudan has delivered several billion dollars of food and supplies. It began as an emergency, and it has, no doubt, saved thousands of lives. It is now known, in a rare bit of bureaucratic frankness, as the ''permanent emergency.'' The war, which has taken some two million lives, simply never ends.

But Nuba, for better or for worse, was left out. The sensitive agreements allowing the outside world into Sudan stipulated that aid to rebel areas would go only to the south; Nuba lies just to the north of the dividing line.

In the 1990's, the war in Nuba worsened, and its exclusion grew into a black mark on the U.N. -- evidence that humanitarianism was a right not for all who suffered but for only those who suffered within the convenient confines of political agreement. The stain was so obvious that in 1998 the secretary general, Kofi Annan himself, muscled a top Sudanese official into agreeing to allow regular aid flights. That promise has yet to be honored.

But over the last few months, an agreement has been taking shape that would allow some 15 U.N. agencies and aid groups into Nuba for regular deliveries of aid. It is hard to say exactly when it will happen, but soon a particular version of the outside world is likely to open up shop amid emptiness.

The Rev. Edward Kocholo Juju was worrying over just this possibility a few days after I arrived in Nuba. Kocholo, 38, is an ethnic Tira, one of the Nuba tribes to hold fast to traditions like ritual scarring. But he is posted to a Roman Catholic parish in southern Sudan, so he has some basis to compare a place with much outside help to Nuba with so little.

''Here in the Nuba Mountains, people are depending on themselves much more,'' he says. ''And in spite of the difficulties, I think we are much better off.''

But better is relative. In almost two weeks of walking around Nuba -- with government Antonov bombers droning nearly every day over the sunburned yellow earth -- it was clear at every turn how much Nuba's exclusion from the world of aid had cost. A team from the United Nations allowed there in 1999 found health standards and infant mortality far worse than in the areas of Nuba controlled by the government. Schooling is minimal. Water is dirty. Rape by government militiamen is frighteningly common. So is goiter from the simple lack of iodized salt.

Self-sufficiency may be the Nuban's greatest strength, but it is also killing them off as a people. It is estimated that nearly one-quarter of the one million Nuba have died or left rebel-controlled areas since 1989. If the Nuba want more, and they do, it will have to come from outside.

So far, the sparse amount of aid dropped in since 1996 has clearly helped. That year, Kowa and Nuba's other leaders, with the help mostly of small church-based outsiders, began bringing in used clothes, medical supplies, soap and salt -- ending six years of complete isolation.

But even that trickle of aid has created needs that, many Nuba and their supporters worry, may distract and undermine their hard-fought unity. This is why Kowa has made the unusual decision to decline food aid in favor of ''capacity building'' assistance when the U.N. begins regular deliveries.

The reason is plain enough. The war in the Nuba Mountains is about precisely these things. The government burns crops, bombs hospitals, targets wells for attack and has bombed at least one school. Aid to Kowa is about saving lives, but it is also, without question, about helping the Nuba as a people resist in this war.

Humanitarianism is, at its core, about war, and war casts its compromising shadow over humanitarianism's good intentions. Aid, it turns out, works much better in natural disasters, earthquakes or floods. When politics provokes the crisis -- when, for example, hunger is deliberately induced as an aim of war -- things get much murkier.

Up through the Second World War, most conflicts were waged between national armies fighting on well-defined battlefields. But since 1945, most wars have been fought inside internal borders. The shift accelerated after the fall of the Berlin Wall, as nasty modern wars broke out in places like Somalia, Bosnia, Rwanda, Kosovo and East Timor.

Without clear, cold-war battle lines, aid groups suddenly found themselves on unfamiliar terrain. The bedrock principle of strict neutrality, laid down by the International Committee of the Red Cross in the 19th century, grew problematic. ''It has become more complicated,'' says Jonathan Mitchell, regional director of East Africa and the Middle East for CARE International, one of the largest aid agencies. ''There are many more sides. There is not a clear, stable political environment to work in. And often -- Sudan is one example -- aid groups are the only stable organizations there.''

Warring parties in many of these new conflicts simply do not follow the old rules, particularly the fundamental one that civilians should be kept out of harm's way. Some experts estimate that civilians account for 90 percent of war deaths since 1945. In many ethnic struggles or internal power plays, civilians are specifically targeted. This makes it more difficult for aid groups to operate but, to the supporters of aid, all the more important that they do.

Just outside a village called Kauda in southeastern Nuba near the airstrip, we went to the school that had been bombed or, more precisely, to the place they had moved the children to be safer in their studies. Four broad trees, green even without rain, shaded four open-air classrooms, with about 230 students in all. Chalkboards were propped up at the roots. Cows mooed; goats bleated. This was all jammed up against a sizable rise of boulders and caves, which the schoolmaster, Baruch Moses, 35, said would be strategically useful in case of another attack.

''For instance, this rock, of course, if a shell fell here and you lay on the other side, nothing would affect you,'' he said. ''Of course.''

The old school, a few hundred yards away, was out in the open, and so made too tempting a target. Last Feb. 8, an Antonov bomber, one of the prehistoric Soviet planes that now do geriatric duty around Africa's wars, made several passes around 9 a.m. Then it dropped three bombs, blowing out a neat line of dusty craters.

''I lay down under the blackboard,'' a thin girl named Farah Mohamed, 12, who was in English class at the time, recalled. ''One of the boys who died, his stomach was cut and his intestine was coming out. Before he died, he came over and laid on me.''

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Fiddling with a twig, she told me that she does not want to go to school anymore. Moses said that he believed this was exactly the intention of the bombing. ''The Khartoum government, they know that most of our schools are going well,'' he said. ''They don't want the Nuba to be educated.'' This is modern war. It's not so much about winning territory as gripping power by uprooting people, cutting at life's basics, seeding terror so that the simplest act is shrouded in uncertainty.

A visit to a small thatched hospital of the German Emergency Doctors, the only international aid group with a regular presence in Nuba, turned up a similar story. Henrick Sauer, 39, a nurse in shorts and a striped shirt that somehow evaded Nuba's dust, talked about how clean water was a problem. But, he said, ''we don't want to rehabilitate the wells, because more and more people come, and it's a big target for bombing.'' Not only the wells. In 1998, the German doctors' old hospital near Kauda was bombed eight times in two weeks.

It was once rare for aid groups to become specific targets of war. But again, old rules no longer apply. Since 1992, more than 190 U.N. workers have been killed on duty. The Red Cross, the most neutral and discreet of aid groups, has had staff members killed in Burundi and Chechnya. This summer, Sudanese war planes actually dropped bombs near planes from the U.N. and the Red Cross in the south.

This increased hostility is partly because warring parties are less likely to believe aid groups are neutral -- at times for good reason. The number of aid groups has risen steeply in the last decade, seeing opportunity in the chaos of crumbling states. Some, like the Red Cross, are pointedly neutral. Others, typically independent operators working under contract to larger outfits, are increasingly taking sides.

More important, aid is a valuable resource in war; it pays to get a lot and make sure your enemy gets little. As one scholar recently described the dynamic, ''War attracted mercy, and mercy transformed war.''

Having foreigners come in and feed the hungry can free armies or rebel groups to buy more weapons. Last year, for example, Ethiopia spent hundreds of millions of dollars on weaponry in its border dispute against Eritrea -- then blamed rich Western governments for not coming in fast enough when people began dying of hunger in southeastern Ethiopia. In southern Sudan, aid workers struggle daily to keep food out of the hands of the main rebel group, the Sudan People's Liberation Army. Aid can even be manipulated into a clever instrument of war, one that the Sudanese government has used in the Nuba Mountains with the reluctant cooperation of the U.N. and other aid groups.

In a village called Durdu, a hard, three-hour walk from Kauda and only a few miles from one of the government garrisons that honeycomb Nuba, I met a man named Tutu Bala. He is 50 but looks weary and much older. In 1991, a government militia raid pushed him from his big family farm in a valley to a tiny, rocky plot in the hillside. He could barely grow enough sorghum, the staple of the Nuba diet, to feed his family.

The next year, the government established what it called peace camps in the areas of Nuba it controls. The idea is this: Government soldiers and militia burn the Nuba's crops, as they did to Bala. Then in times of drought, Nuba from the rebel-controlled areas flee their homes because they know the camps provide at least a minimum of food. They are essentially starved out.

Bala held on until drought hit in 1998, forcing him into one of the peace camps. ''We had no food,'' he said. He had returned home only three weeks before I met him. He still had nothing.

In the mid-1990's, the U.N. World Food Program and several private aid groups began working in and around the camps. Their presence was morally difficult. They were caring for truly needy people. At the same time, the aid was a magnet to draw the Nuba out, thus helping the government's war strategy to drain Nuba of people who might fight it.

No one's hands are especially clean.

Many critics blame aid organizations more broadly. Aid, the critics say, has become a multibillion-dollar industry of compassion that cannot do without war and plague.

Those who give aid do so inconsistently. Rich Western governments, which donate the bulk of the money to private aid groups, act with great outrage in areas that are important to them.

Kosovo became the first ''humanitarian'' war, in which the rationale for NATO's bombing was largely to help tens of thousands of Kosovars pushed from their homes. But they are far less committed to Africa.

In the face of such ambiguities, the temptation is to declare defeat and withdraw from the world's violent corners. But that will not happen, in part because outsiders really do want to help. More cynically, it is cheaper for rich governments to give money to handle emergencies than to engage in a more enduring way.

Either way, the option is awful.

''What is the alternative?'' Catherine Bertini, the executive director of the U.N. World Food Program, asked in an interview last spring. ''As President Reagan declared, 'A hungry child knows no politics.'''

''I am an optimist,'' says Mary B. Anderson, who is at the moment the most influential theorist in the world of humanitarianism. ''But I am a pretty realistic one.''

Anderson, a pacifist Quaker and an economist, is the intellectual force behind what is often called the ''do no harm movement.'' Her ideas developed in the early 1990's as she traveled around the world's hot spots as a consultant to governments or aid groups. She listened as colleagues discussed the same things: soldiers stealing food; relief food giving some local warlord resources, and thus power, that he would not otherwise have had.

''It began to occur to me that there were patterns here,'' she tells me by telephone from Cambridge, Mass., where she is based.

Her method is not poetry. She advises a strict analysis of the good and bad of any aid effort and to find ways around the bad. Practical ways, for example, to end soldiers' stealing food. Aid agencies, she argues, can work more closely with parts of society that have a greater commitment to peace or, at least, to relief functioning as envisioned.

She does not, however, advocate going so far as to stop giving aid. ''Not to give aid can also cause harm,'' she says. ''The decision not to give aid plays into war. We are embroiled whether we like it or not.''

Partly as a result of Anderson's work, CARE evaluated its programs in Sudan in 1998 and decided it was hard to justify aid to the ''peace camps'' if it was not also helping out in the rebel-controlled Nuba Mountains.

I met one day with Mitchell, the CARE official, in his office in Nairobi. He is solid and thoughtful, not at all the caricature of aid workers as self-righteous do-gooders or New Age careerists. The mere fact that he talked about Nuba underscored a big change for many aid groups: making public their frustration, even anger, to put pressure on a government like Sudan's.

And though he would not say it directly, he seemed to be taking Anderson's method to an extreme she would avoid: his ''do no harm analysis,'' it seems, calls for pulling out of the government-controlled parts of Nuba if Sudan does not deliver on its promise to allow aid groups to go elsewhere. ''We do have an internal timetable on our participation in terms of access to the Nuba Mountains,'' Mitchell says. ''But it would not be productive to discuss that in public.''

Just as Anderson's work is playing out in the Nuba Mountains, so, too, are other ideas for improving humanitarian aid. The difficulty is that there is no overarching theory. Instead, there is a collection of small refinements. Some believe there should be an ombudsman, a sort of humanitarian czar, to oversee the world's relief efforts. Others say aid groups should get more involved in protecting human rights.

A tall smoker of hand-rolled cigarettes named Justin Corbett is one of those who believes a solution rests in giving those who are helped far more say in what they receive. His office in a house on the outskirts of Nairobi is cluttered with papers and charts drawn with markers -- all plans for aid projects in the Nuba Mountains. He is one of several people that Nuba's leaders are consulting to help them figure out what aid is best for them.

''Oh, the road to hell is paved with the best intentions,'' he says. ''So as outsiders, a few of us would be very concerned about the U.N. and the rest of us moving in. But the Nuba have this same worry.''

For the last several years, the local Nuba aid group, working with Corbett and others, has been experimenting with small, specific aid projects. It has worked to set up weavers and beekeepers and banks with sorghum to get the Nuba through lean times. It has even experimented with giving the Nuba cash to buy food or other supplies, because it is so hard, and dangerous, to bring goods in by air.

For their part, the U.N. and aid groups have been more than eager to adopt the model the Nuba want. After being criticized for treating local people as incidental -- and establishing little of permanence with food -- aid groups have been experimenting for several years in southern Sudan with projects like building medical clinics, wells and schools. And the Nuba's plan suits their own desire to succeed in a new direction -- and maybe even taste redemption.

Nuba, says Roger Guarda, a top U.N. official in Khartoum, is basically an untouched area for aid. ''This is the right laboratory.''

If it goes as planned, all of this may work well for the Nuba people. It may just make their lives better, with less chance that it will change the Nuba or their culture significantly. But it also implies a shift in course for humanitarianism, toward a route more politically engaged, less neutral.

The mere presence of the U.N. and aid organizations will give the Nuba a legitimacy they have so far lacked. For the first time, the eyes of the outside world will be in Nuba regularly, watching and documenting the war -- though that, of course, is not primarily what aid is supposed to do.

Controlling the aid will give the Nuba power, though the practice is contentious because of well-documented fears that local leaders will abuse the largess they receive. And the specific kinds of aid -- water, seeds, educational materials -- will directly help the Nuba fend off a war that, at base, is about scaring or starving people out.

In some ways, none of this is new. In various forms and extremes, it is what some experts call ''political humanitarianism.'' It implies, if not outright solidarity, a degree of advocacy or sorting out of the good guys from the bad, of making a war's resolution part of aid's equation. Aid groups are speaking out more often and pulling out when their presence seems more harmful than good. It is a role nearly everyone in the aid world is approaching gingerly -- for all it implies about loss of neutrality -- if with a sense of inevitability.

''I vacillate a little bit on this,'' says Mark Bradbury, a British aid consultant with long experience in Sudan and the Nuba Mountains. ''You start making distinctions between good victims and bad victims and deserving victims and non-deserving victims.

''At the same time, I'm not sure that the way in which humanitarian aid has been traditionally managed can continue.''

''Managed'' is an oddly apt word. What humanitarianism has been unable to do, despite ever-larger expectations and a century and a half of trying, is to manage war. War is the problem, and aid -- in whatever incarnation -- is only the lesser part of a solution. ''We are not in need of clothes or salt,'' an old man, Ibrahim Bringi, in white robes and clutching a cane, tells me under a tree one hot afternoon in Nuba. ''The main thing we need is for this war to be solved. You can bring whatever you like here. If this war continues, it will mean nothing.''